Key result
IgG immunoassays demonstrated a higher pooled sensitivity (0.93) for diagnosing allergic bronchopulmonary aspergillosis compared to IgE (0.83), whereas IgE exhibited higher specificity (0.89 vs 0.73).
Why the study?
Most diagnostic criteria consider Aspergillus-specific IgE key and IgG auxiliary, but no conclusive study has summarized the performance of IgG and IgE in diagnosing ABPA.
Does detecting Aspergillus-specific IgG compared to IgE improve diagnostic accuracy for ABPA?
Meta-Analysis (n=1,127)
Does detecting Aspergillus-specific IgG compared to IgE improve diagnostic accuracy for ABPA?
IgG detection has higher sensitivity but lower specificity than IgE for diagnosing ABPA, suggesting IgG may play an important role in filtering potential ABPA patients.
Answers are grounded in this paper and cite their sources.
IgG offers higher sensitivity for ABPA detection than IgE; extends diagnostic criteria evaluation with quantified performance trade-offs.
Background Hitherto, the bulk of diagnostic criteria regards Aspergillus -specific immunoglobulin E as a key item, and regard IgG as an auxiliary method in diagnose. Nevertheless, there is no conclusive study in summarize the performance of IgG and IgE diagnosing ABPA. Methods We conducted a systematic review to identify studies report results of IgE and IgG detection in diagnosing ABPA. QUADAS-2 tool was used to evaluate included studies, and we applied the HSROC model to calculate the pooled sensitivity and specificity. Deeks’ funnel was derived to evaluated the public bias of included studies, and Cochrane Q test and I 2 statistic were used to test the heterogeneity. Results Eleven studies were included in this study (1127 subjects and 215 for IgE and IgG). Deeks’s test for IgE and IgG were 0.10 and 0.19. The pooled sensitivity and specificity for IgE were 0.83 (95%CI: 0.77, 0.90) and 0.89 (0.83, 0.94), and for IgG were 0.93 (0.87, 0.97) and 0.73 (0.62,0.82), with P value < 0.001. The PLR and NLR for IgE were 7.80 (5.03,12.10) and 0.19 (0.13,0.27), while for IgG were 3.45 (2.40,4.96) and 0.09 (0.05,0.17). The combined diagnostic odds ratio and diagnostic score were 41.49 (26.74,64.36) and3.73 (3.29,4.16) for IgE, respectively, and were 38.42 (19.23,76.79) and 3.65 (2.96,4.34) for IgG. Conclusion The sensitivity for IgG diagnosing ABPA is higher than IgE, while the specificity for IgE is higher. IgG might be able to play a more important role in filtering ABPA patients.
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Liu et al. (2023) conducted a meta-analysis in Allergic bronchopulmonary aspergillosis (ABPA) (n=1,127). IgG immunoassay vs. IgE immunoassay was evaluated on Pooled sensitivity for diagnosing ABPA (95% CI 0.87-0.97, p=<0.001). IgG immunoassays demonstrated a higher pooled sensitivity (0.93) for diagnosing allergic bronchopulmonary aspergillosis compared to IgE (0.83), whereas IgE exhibited higher specificity (0.89 vs 0.73).
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